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CAH361316-00 BUCYRUS COMMUNITY HOSPITAL (Active)
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Main Details
Name
BUCYRUS COMMUNITY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH361316-00
Medicare Provider Number
361316
Additional Details
Current Program Status
Active
Registration Date
9/10/2010
Participating Start Date
1/1/2011
Participating Approval Date
9/13/2010
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
Avita Health System
Eric Draime, CFO
(419) 468-0501
Primary Contact
Avita Health System
Christina Barnes, Director of Pharmacy
(419) 468-0541
Addresses
Street Address
629 N SANDUSKY AVENUE
BUCYRUS, OH 44820
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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3/30/12 - Deleted NPI # (was 1112843) 9/21/10 PER CE REQUEST, START DATE CHANGED TO 1/1/11 (WAS 9/14/10)
03/30/2012
9/21/10 PER CE REQUEST, START DATE CHANGED TO 1/1/11 (WAS 9/14/10)
09/21/2010
April 2025
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